“It was only a matter of time” before monkeypox reached places, a pediatric infectious disease specialist said Conditionafter Illinois state officials announced Friday that a daycare worker had been diagnosed with the virus associated with smallpox.
“There’s definitely potential for monkeypox to spread” in daycare centers, schools, college campuses, prisons and other such places, said Dr. Alexandra Brugler Younts, an infectious disease specialist at Children’s Nationwide Hospital in Washington, DC. She helped with the FDA review of Jynneos, one of two smallpox vaccines licensed to treat monkeypox, and the safer of the two by far.
“Anywhere that close physical skin-to-skin contact happens — especially with people who are in various stages of undress — there’s a risk,” she said.
All children and adults at the unidentified day care center in Champaign County, Illinois, were screened and no additional cases were identified, state health officials said Friday, adding that Gov. JB Pritzker is in contact with the White House about the situation.
But schools and life gathering places aren’t the only places ripe for distribution, Brugler Yonts said. Also on her list of places where transmission can occur: pools and water parks — “not through the water, but by bumping into someone with active lesions — especially in the summer, given the heat and the tendency to minimize clothing.”
Contact sports like football and wrestling can also prove problematic, she added.
“Hopefully outbreaks can be contained more locally, but as people continue to travel, take part in [aforementioned] activities, and then with school starting soon…. I think this will be more widespread. There are now cases in almost every US state.
As of Friday, 7,510 cases had been identified in the US, with the majority of cases in New York, California and Florida, according to data from the US Centers for Disease Control and Prevention. Every state except Wyoming and Montana has identified cases.
More than 28,000 cases have been reported worldwide since January, almost all in countries where monkeypox is not considered endemic, according to the CDC. The US now leads the world in identified cases, followed by Spain, Germany, the UK, France and Brazil. Only 345 cases have been observed since January in African countries where the virus is considered endemic. Eighty-one children were infected by the end of July, according to the World Health Organization.
Illinois health officials on Friday said the U.S. Food and Drug Administration had cleared the use of Jynneos, licensed for use in adults 18 and older, for potentially affected children at the center “without going through normal hoops.” Mobile testing and vaccination services were in place, they added.
An FDA spokesman told Fortune by email on Friday that the vaccine was approved for such children through a “single-patient expanded access new drug application” filed for each of them. Applications are processed “as expeditiously as possible” and approved “when no comparable or satisfactory alternative options are available and are requested by treating licensed physicians who determine whether the benefits outweigh the likely [sic] risk.”
The spokesperson did not comment further on the possibility of general approval for the use of Jynneos in children.
Because Jynneos is licensed and not just authorized under an emergency use permit, as the original COVID vaccines were, it can be used “off-label” — for example, given to children who have been exposed, Brugler Yonts said. .
Researchers “will certainly want to gather data on safety and, if possible, on immunogenicity in these children and follow them closely because there are no preexisting data on use in the pediatric population,” she said. “But Jynneos is safe, and if this can prevent a larger outbreak in the pediatric population – and of course the adults who care for them and live with them – that’s very important.”
The decision to provide the vaccine to children is “worth the potential risk,” she added.
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